MACKENZIE GRAYE MCMILLIN (NPI# 1558923326) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558923326 |
| Entity Type | Individual |
| Full Name | MACKENZIE GRAYE MCMILLIN |
| Credential | PA-C |
| Practice Address |
1601 Congress St Ste 1 Portland ME 04102-2145 |
| Mailing Address |
212 Coyle St Portland ME 04103-4006 |
| Practice Telephone | 2077745113 |
| Mailing Telephone | 9372070677 |
| Enumeration Date | 2019-07-02 |
| Last Update Date | 2019-07-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PAN1918 | ME | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1601 CONGRESS ST STE 1 |
| City | PORTLAND |
| State | ME |
| Zip Code | 04102-2145 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720602964 | Ci Yen Joanna Man | Student in an Organized Health Care Education/Training Program | 190 Park Ave., Portland, ME 04102 | 2020-06-03 |
| 1841811338 | Abby Zarotny Sahagian | Nurse Anesthetist, Certified Registered | Mmc Anesthesia and Perioperative Medicine, 22 Bramhall St, Portland, ME 04102 | 2020-05-06 |
| 1124656863 | Zachary Bernard Tillett | Student in an Organized Health Care Education/Training Program | Maine Medical Center 22 Bramhall St., Portland, ME 04102 | 2020-03-30 |
| 1215564323 | Joshua Allen Swenson | Student in an Organized Health Care Education/Training Program | 33 Bramhall St, Portland, ME 04102 | 2020-03-26 |
| 1740776434 | Rishi Phakey | Dentist | Community Dental, 190 Park Ave, Portland, ME 04102 | 2018-07-05 |
| 1982192571 | Jessica Thomas | Doula | 619 Brighton Ave #101, Rosemont Wellness Center, Portland, ME 04102 | 2018-04-29 |
| 1699270744 | Shane D Kirkegaard | Student in an Organized Health Care Education/Training Program | Maine Medical Center 22 Bramhall Street, Portland, ME 04102 | 2018-03-29 |
| 1144752494 | Al-shawk Home Healthcare, LLC | Technician | 640 Brighton Ave Ste 8, Portland, ME 04102 | 2017-03-28 |
| 1376074674 | Samuel B Potter | Emergency Medicine | Maine Medical Center, 22 Bramhall Street, Portland, ME 04102 | 2017-03-27 |
| 1043767536 | Kevin De Ruiter | Social Worker | 129 Pine St Apt 6, Portland, ME 04102 | 2016-09-01 |
| Find all providers in zip 04102 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427676493 | Lindsey Louise Peterson | Physician Assistant | 3505 N Williams Ave, Portland, OR 97227-1437 | 2020-07-07 |
| 1518584036 | Abigail Nichole Dumont | Physician Assistant | 6064 Sw 30th Ave, Portland, OR 97239-1018 | 2020-06-30 |
| 1336769637 | Molly Tanguay | Physician Assistant | 23 Bramhall St, Portland, ME 04102-3121 | 2020-04-16 |
| 1063040525 | Jessica Nursick | Physician Assistant | 26 Sand Hill Rd, Portland, CT 06480-1737 | 2020-03-31 |
| 1689217630 | Evan Eisher | Physician Assistant | 3809 Se Stephens St, Portland, OR 97214-5248 | 2019-10-22 |
| 1508407941 | Amie Bates | Physician Assistant | 1040 Nw 22nd Ave # Ll030, Portland, OR 97210-3057 | 2019-10-07 |
| 1447812268 | Maksim Yefimov | Physician Assistant | 2800 N Vancouver Ave Ste 130, Portland, OR 97227 | 2019-07-01 |
| 1942794839 | Michael Peterson | Physician Assistant | 3181 Sw Sam Jackson Park Rd # P31, Portland, OR 97239-3098 | 2018-06-14 |
| 1306383930 | Rachel Lynn Witowski | Physician Assistant | 2124 Nw Hoyt St, Portland, OR 97210-3215 | 2017-01-20 |
| 1700330149 | Lance Martin Stang | Physician Assistant | 606 Ne Broadway St, Portland, OR 97232-1212 | 2016-08-14 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.